CARE-SEEKING BEHAVIOR AMONG SUBJECTS WITH EARLY CHRONIC OBSTRUCTIVE LUNG DISEASE IDENTIFIED THROUGH A COMMUNITY SPIROMETRY SCREENING PROGRAM: FINDINGS FROM THE RESPIRATORY HEALTH PROMOTION STUDY (RHPS)FREE TO VIEW

Abstract

PURPOSE: To assess care-seeking behavior among subjects with chronic obstructive lung disease (OLD) identified in the community in the year following an initial spirometry screening test.

METHODS: The Respiratory Health Promotion Study (RHPS) is an ongoing prospective, longitudinal study initiated as part of employer and community wellness activities offered by a local health plan. Subjects aged 25+ years are eligible if they provide valid spirometry readings and complete a respiratory health questionnaire (RHQ). The RHQ includes items related to respiratory symptoms, activity limitations, healthcare resource use, and perceived health status. Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria were used to classify study subjects at baseline as having OLD (FEV1/FVC <0.70; stages 1-4) or no OLD (FEV1/FVC ≥0.70). For those with OLD, spirometry and the RHQ, along with items concerning behavior change, are administered one year after study enrollment.

RESULTS: 382 subjects with OLD enrolled in RHPS through February 2006. To date, 71 completed baseline and one-year follow-up questionnaires and were included in this analysis. These subjects had a mean age of 64 years, 32% were male, 18% were current smokers, 60% were former smokers, 82% were in GOLD stages 1 or 2, and 32% were previously aware of their chronic respiratory disease. One year following the initial spirometry test, 45% of subjects reported visiting their healthcare professional and discussing test results. The most common actions were prescribing medication for breathing problems (30%) and ordering of more tests (15%). Of the 13 smokers at baseline, 3 reported quitting smoking.

CONCLUSION: A substantial proportion of subjects identified in the community as having OLD discussed spirometry test results with their healthcare professionals. About one-half of those seeking care received additional tests or treatment.

CLINICAL IMPLICATIONS: Following community-based spirometry screening, many persons identified as having OLD sought care from their healthcare professionals, which had the effect of modifying treatment practices. Whether such screening programs improve outcomes is an important topic for future studies.

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Care-seeking behavior among subjects with early chronic obstructive lung disease identified through a community spirometry screening program: findings from the respiratory health promotion study (rhps)

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